Beja Jackson
Technician, Attendant Care Provider in Roanoke, VA. Individual provider (NPI-1).
NPI number1124875448
StatusActive
Last updated in NPPESMay 3, 2024
Details
- NPI
- 1124875448
- Entity type
- Individual (NPI-1)
- Name
- Beja Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 3, 2024
- Certification date
- May 3, 2024
- Last updated
- May 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | VA | Yes |
Practice location
1423 Gilbert Rd NwRoanoke, VA 24017-2637
Phone 540-598-1972
Mailing address
1423 Gilbert Rd NwRoanoke, VA 24017-2637
Phone 540-598-1972
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